MEDICARE: MIND DOJO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	103T00000X	Psychologist
4	261QH0100X	Health Service Clinic/Center
5	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1730805763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND DOJO LLC

Provider Business Mailing Address
First Line	:	1059 GIULIA DR
Second Line	:
City	:	IRWIN
State	:	PA
Zip	:	15642-4187
Country	:	US
Telephone Number	:	724-755-3922
Fax Number	:

Provider Business Practice Location Address
First Line	:	8958 HILL DR
Second Line	:
City	:	IRWIN
State	:	PA
Zip	:	15642-3112
Country	:	US
Telephone Number	:	724-755-3022
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. LAUREN GRAWERT
Credential	:	MD
Telephone Number	:	724-755-3022

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	03/05/2026

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Directions to “MIND DOJO LLC ” Practice Location

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